Will Texas See Medical Cannabis Expansion in 2023?
In the state of Texas, medical cannabis is legalized. That provides another doctor-supervised treatment option for patients with chronic diseases. And that is a good thing because Texas has a large population of patients with debilitating health conditions.
While Texas is one of the top states for economic growth, it is also one of the lowest-ranking states for population health. The United States Census data from 2020 revealed that Texas had grown by more than 4 million residents in recent years. More growth than any other state on the record for the past decade.
However, in a 2020 article, “The Fastest-Growing U.S. States Have the Worst Health Care,” Harvard Business Review (HBR) ranked Texas 42nd in terms of health system performance primarily because health insurance is difficult for people in the Lonestar State to get and afford. And because Texas has the highest uninsured rate in the country regarding health coverage.
With healthcare costs creating barriers for patients in Texas, an expanded medical cannabis program could help. It would provide a more economical alternative for chronic pain symptoms and compassionate care for patients with HIV and cancer. But the state maintains a very restrictive medical cannabis program.
Will Texas see a medical cannabis program expansion in 2023? There are many patients and providers in the state that hope so. But there are some significant hurdles to overcome before Texas patients may see a different program that creates a tremendous positive impact on population health.
Reasons Why Texas Needs to Expand the Medical Cannabis Program
When surrounding states like Oklahoma, Arkansas, and New Orleans have patient-centric and accessible medical cannabis programs, it’s hard to understand why Texas does not. And it is frustrating for millions of Texans who could benefit from alternative medicine as an affordable treatment option.
So why hasn’t Texas created an accessible medical cannabis program? Here are some reasons Texas should consider a significant expansion of the state’s current medical marijuana laws.
No Expansion of Medicaid Under the Affordable Care Act
Did you know that Texas is one of the states that has not expanded Medicaid provisions under the Affordable Care Act? The ACA Medicaid expansion provided additional coverage to adults with incomes up to 138% of the Federal Poverty Level ($17,774 per annum for single individuals in 2021).
Under the Affordable Care Act, the federal matching rate (FMAP) was enhanced to provide additional funds to states. That meant more people with lower incomes could access affordable healthcare in the country. But eight years later, it has still not been provided for residents of Texas, despite being available effective January 1, 2014.
This infographic provided by healthinsurance.org demonstrates how the choice to deny Medicaid expansion is impacting lower-income patients and families in Texas.
As of 2022, few states have approved Section 1115 waivers to “operate their Medicaid expansion programs in ways not otherwise allowed under federal law,” according to the source. That includes Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, Utah, and Texas.
On May 5, 2022, Texas Health and Human Services released a plan to end the Covid-19 Medicaid emergency provisions earlier than required by the federal government. While the number of Americans without health insurance in 2022 declined significantly, that was not the case in Texas.
The Medicaid Gap Created a Negative Shift in Population Health
There is a coverage gap impacting people with low income in Texas. Where individuals are right on the line in terms of annual income but still do not qualify for access to Medicaid. Just over 770,000 Texans fall in that category. And currently, patients without a disability (and individuals who are not pregnant) are only eligible if they earn less than 14% of the poverty level.
There has been a negative shift in population health in Texas, and Medicaid enrollment has grown by 27% since 2013. Much of that growth is attributed to COVID-19, and the federal government “relaxed” Medicaid rules to enable more patients in need to stay on the national health insurance program.
The federal government reported that 45% of Texas adults aged 19-64 with an income under 138% of the poverty level were uninsured in 2020. That year, Texans had the highest health uninsured rate in the country.
Meanwhile, Texas receives billions every year in federal funding for uncompensated care. This does not make it to all of the patients in need. Some leaders in Texas have not pursued the expansion of Medicaid as a priority. Instead, maintaining the 1115 waiver established in 2011 was meant to be a temporary measure to provide funding for uncompensated care.
How Many Patients Have Chronic Health Conditions in Texas?
An estimated 133 million Americans are living with at least one chronic illness. That includes hypertension, heart disease, diabetes, and arthritis. That is almost half of the population of the United States. And many patients suffer from multiple chronic diseases.
According to the Centers for Disease Control and Prevention (CDC), there are ten leading causes of death for residents of Texas, many of which are rooted in chronic diseases.
- Heart Disease
- Alzheimer’s Disease
- Chronic Lower Respiratory Diseases
- Chronic Liver Disease (Cirrhosis)
- Kidney Disease
In 2020, the state of Texas had the second-highest mortality rate (250,339) in the United States, behind California (319,808). Continuity of healthcare provision and access to affordable healthcare may be the primary contributing factors.
Currently, 1 in 5 Texas adults has been diagnosed with a chronic disease. And chronic disease(s) account for 60% to 70% of patient deaths in the state.
How Many People Are Registered Patients for Medical Marijuana in Texas?
The Compassionate Use Act was passed in 2015, and it allowed doctors to prescribe cannabis to qualified patients. Texas is one of the few states that refers to medical cannabis recommendations by a physician as a ‘prescription.’ And that is an indication of the difference between the medical cannabis program in Texas and other states.
In a report from Austin KXAN, Chief Wayne Mueller of the Texas Department of Public Safety predicts an increase in registered patients. In fact, Mueller stated that there has been a significant uptick in patient registration for medical cannabis in 2021 and 2022.
Chief Wayne Muller also predicted that within twenty-four (24) months, the number of patients enrolled in the Texas medical cannabis program would exceed 100,000. And indicated an enrollment growth of 10% month over month for the past year.
The data provided by the Compassionate Use Registry in Texas confirms Mueller’s statement about the rapid growth of patients enrolled in the program. The number of people who have become registered for medical cannabis in Texas is escalating.
- January (18,047)
- February (19,805)
- March (22,221)
- April (24,638)
- May (26,687)
- June (29,082)
- July (31,581)
- August (34,128)
- September (36,651)
- October (38,953)
Source Web 2022: dps.texas.gov
There are three licensed providers or dispensaries in Texas that fulfill patient ‘prescriptions’ for medical cannabis. They are Texas Original, goodblend, and Fluent. But before patients can receive medical cannabis products, a licensed medication provider must approve them.
What Are the Current Qualifying Health Conditions in Texas?
Comparing the list of qualifying health conditions for medical cannabis in Texas to other states, you quickly see how limited it is. Most states have at least fifteen qualifying health conditions, and some have over twenty. And they are diagnoses that span chronic diseases, end-of-life needs (compassionate care), and debilitating mental health symptoms.
In 2022, only nine qualifying health conditions may make a patient eligible to receive doctor-supervised medical cannabis.
- A seizure disorder
- Multiple sclerosis
- Amyotrophic lateral sclerosis
- Post-traumatic stress disorder (PTSD)
- An incurable neurodegenerative disease
Under the qualifying condition of “an incurable neurodegenerative disease” is a more broad list of diagnoses that may be eligible. That includes patients in Texas with Alzheimer’s disease, Parkinson’s disease, multiple system atrophy, progressive supranuclear palsy, Ataxia, and Glaucoma may be qualified.
There are a large number of patients who do not qualify for medical cannabis. Many of them would qualify in other states but, given the restrictions, are not able to access doctor-supervised cannabis for symptom management.
Some of the “missing” qualifying health conditions that could be added as a further expansion of the Texas Compassionate Use Program (CUP) include:
- Chronic pain
- Anorexia and Bulimia
- Crohn’s disease
What is more frustrating for patients in Texas is that patients in nearby Oklahoma can now be approved for any health condition. It is left to the discretion of the primary care physician, who can authorize any patient who may benefit from medical cannabis.
Will Texas Patients See an Expanded Medical Marijuana Program Soon?
On the topic of the movement to decriminalize cannabis in jurisdictions across the state of Texas, Marijuana Moment referred to a recent poll that captures the growing support for medical cannabis. More than 60% of respondents in the poll favored adult use (recreational), while 9 out of 10 surveyed felt that cannabis should be legalized for some purpose, i.e., doctor-supervised use.
In the November 2022 election, voters in Denton, Killeen, San Marcos, Elgin, and Harker Heights will be deciding on policy changes regarding cannabis arrests and convictions. In 2023, San Antonio, Texas, voters will also be casting ballots on the topic of cannabis legal reform. But has the state of Texas reached a tipping point in terms of changing social sentiment about alternative medicine? It appears that way.
Expansion of the medical cannabis program in Texas would reduce barriers to alternative health. And provide new options for patients with debilitating chronic diseases to manage their symptoms better.
Voters will determine the trajectory and possibility of a new and more accessible medical cannabis program in 2023. And many patients with chronic diseases and painful conditions are hoping that happens soon. As a resident of Austin, Texas, and a patient with diabetic neuropathy, my fingers are crossed too.